1,720,975 research outputs found
Managing diabetes in people with foot complications
No full textThe high prevalence of diabetic foot disease is a concern. Many preventable amputations are performed every week, with high levels of associated morbidity and mortality. This chapter outlines what should happen if a healthcare professional suspects acute foot disease in a patient with diabetes. Relevant aspects of acute care are also discussed, such as the importance of managing hyperglycaemia in these patients, the need to involve a specialist diabetes team and ways to reduce cardiovascular risk. Post-discharge guidance is also outlined to promote better diabetes self-care by patients, with the support of appropriately trained healthcare professionals
Raw Data for Thesis: Effectiveness of Nerve Conduction and TcPO2 in screening for Neuroischaemia in People with Type 2 diabetes
No full textThis dataset supports the thesis entitled : The Effectiveness of Nerve Conduction and Transcutaneous Oxygen Devices Against Existing Methods in Screening for Neuroischaemia in the Feet of Adult Participants With Type 2 Diabetes in the Community by Tanyanyiwa.</span
Palpating for abdominal aortic aneurysms within a specialist podiatrist and nurse-led peripheral arterial disease service: a pulse too far?
No full textThe short-term impact of non-removable offloading devices on quality of life in people with recurrent diabetic foot ulcers
Full text linkObjective: Recurrent diabetic foot ulcers (DFUs) are associated with poor health-related quality of life and reduced mobility. Current guidelines recommend application of non-removable offloading devices (NROLDs) as they may improve the healing of DFUs, but there is a lack of information on the wider effects of wearing these devices. Few studies have examined the impact of NROLDs on holistic wellbeing or physical activity. We aimed to investigate the short-term impact of NROLDs on physical activity and DFU-related quality of life (DFU-QoL) in a small sample of community-dwelling people with recurrent DFUs.Method: We measured DFU-QoL and physical activity (GPAQ) in people with DFUs, recruited from a single clinic before NROLD application, and at three and six weeks after device fitting. Participants were aged from 39-81 years (mean 58.4±10.1 years) with an equal number of male and female participants.Results: The study cohort comprised 18 participants, of whom 14 (78%) completed six-week questionnaires. Although there was some interim decline observed within individual domains of the DFU-QoL (financial: mean difference (MD) 16.2 (95% confidence interval (CI) 2.1, 30.2); p=0.03); non-compliance: MD 12.5 (95% CI-0.2, 25.2); p=0.05), no differences were observed over six weeks. Levels of physical activity declined over time, with over half (56%) of participants classified as having low levels of physical activity at baseline, rising to two-thirds (67%) at follow-up.Conclusion: Future studies should explore the longer-term holistic impact of NROLDs and develop more personalised approaches to care at the point of prescription, during and post-device use
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Educational design insights for interprofessional immersive simulation to prepare allied health students for clinical placements
No full textBackground: positive outcomes of simulation programmes to prepare students for placement are widely noted. However, few studies adequately describe considerations for designing allied health placement simulations. There exists a conceptual framework to guide such simulation design, which draws on theory and educational expertise but to date lacks varied stakeholder perspectives. This study aimed to identify implications for the design of allied health placement simulation from participants’ experiences of a simulation-based, interprofessional, novice placement preparation programme. Methods: occupational therapy, physiotherapy and podiatry students finishing their first year of study were offered a 1-week intensive interprofessional simulation immediately before their first placement. Focus groups in the following weeks allowed participants to discuss their experiences of the programme, preparation for student placements, and recommendations. These were transcribed and interpreted using reflexive thematic analysis and then abductively related to the conceptual framework.Results: in total, 22 participants broadly representative of the simulation programme participants contributed to separate focus groups with domestic-enrolled students (n = 7), international students (n = 5), external practice educators (n = 6), and simulated participants (n = 4). Inductive reflexive thematic analysis generated six themes: (i) engaging learning environment, (ii) realism and relevance, (iii) student confidence and communication, (iv) international students’ needs, (v) recommendations to facilitate further preparation for placement, and (vi) importance of preparation to engage in simulation. All participant groups were invested in the programme and highlighted learning opportunities. An immersive and relatable experience with active participation contributed to confidence and communication skill development. International students noted needs pertaining to cultural and language expectations. Other participant recommendations related to the equity of opportunities and specific preparation for placement student-educator interactions. Finally, every participant group noted features of effective preparation for simulation-based education.Conclusions: Relating these findings abductively to the literature and conceptual frameworks, this study highlights simulation design considerations for learner needs assessment, engagement, realism, psychological safety, and challenge to prepare learners for their first clinical placement. Specific implications for adequately preparing all participant groups, design considerations for the needs of culturally diverse students, and balancing interprofessional and discipline-specific learning are highlighted from a lived experience viewpoint. Future research may engage greater stakeholder co-design in simulation-based education.<p/
Higher body fat percentage is associated with enhanced temperature perception in NAFLD: results from the randomised Wessex Evaluation of fatty Liver and Cardiovascular markers in NAFLD with OMacor thErapy trial (WELCOME) trial
No full textAims/hypothesisThe effect of n-3 fatty acid treatment on temperature perception as a sensory nerve function modality is uncertain. In patients with non-alcoholic fatty liver disease (NAFLD) both with and without type 2 diabetes, we: (1) tested whether 15–18 months’ treatment with 4 g/day of docosahexaenoic plus eicosapentaenoic acid (DHA+EPA) improved hot (HPT) and cold (CPT) temperature perception thresholds and (2) explored factors associated with HPT and CPT, in a randomised, double-blind, placebo-controlled trial.MethodsThe effect of treatment (n=44) on HPT, CPT and temperature perception index (TPI: difference between HPT and CPT) was measured at the big toe in 90 individuals without neuropathy (type 2 diabetes; n=30). Participants were randomised 1:1, using sequential numbering, by personnel independent from the trial team. All participants and all members of the research team were blinded to group assignment. Data were collected in the Southampton National Institute for Health Research Biomedical Research Centre. Treatment effects and the independence of associations were testing by regression modelling.ResultsMean±SD age was 50.9±10.6 years. In men (n=53) and women (n=37), HPTs (°C) were 46.1±5.1 and 43.1±6.4 (p=0.02), CPTs (°C) were 22.7±3.4 and 24.5±3.6 (p=0.07) and TPIs (°C) were 23.4±7.4 and 18.7±9.5 (p=0.008), respectively. In univariate analyses, total body fat percentage (measured by dual-energy x-ray absorptiometry [DXA]) was associated with HPT (r=–0.36 p=0.001), CPT (r=0.35 p=0.001) and TPI (r=0.39 p=0.0001). In multivariable-adjusted regression models, adjusting for age, sex and other potential confounders, only body fat percentage was independently associated with HPT, CPT or TPI (p=0.006, p=0.006 and p=0.002, respectively). DHA+EPA treatment did not modify HPT, CPT or TPI (p=0.93, p=0.44 and p=0.67, respectively). There were no important adverse effects or side effects reported.Conclusions/interpretationHigher body fat percentage is associated with enhanced temperature perception. There was no benefit of treatment with high-dose n-3 fatty acids on the thresholds to detect hot or cold stimuli.Trial registration:ClinicalTrials.gov NCT0076051
Preparing allied health students for placement: a contrast of learning modalities for foundational skill development
No full textBackground: with increasing pressure on placement capacity for allied health students, a need for novel and creative means through which students can develop foundational skills and prepare for practice-based learning opportunities has arisen. This study aimed to explore the experiences of domestic and international first-year students completing pre-clinical preparation programs, contrasting between in-person simulation and online options to contribute to best practice evidence for program design and delivery.Methods: first-year students from physiotherapy, podiatry and occupational therapy self-selected to either a one-weeklong in-person simulation program or an online preparation for placement program. An integrative mixed-methods approach was employed. Qualitative findings from student focus groups were analyzed by reflexive thematic analysis and complemented by quantitative pre-post questionnaires which were examined for patterns of findings.Results: there were 53 student participants in the study (simulation n = 29; online n = 24). Self-selecting, international students disproportionately opted for the simulation program while older students disproportionately selected the online program. Students appeared to benefit more from the simulation program than the online program, with alignment of focus group findings to the quantitative questionnaire data. The in-person simulation allowed students to apply their learning and practice patient communication. All simulation students reported asubsequent increase in confidence, although this seemed particularly marked for the international students. By contrast, the online program was most effective at developing students' clinical reasoning and proficiency with documentation. Both programs faced minor challenges to student perceived relevance and skill development.Conclusion: both online and in-person simulation preparation programs were perceived to enhance readiness and foundational skills development for novice allied health students, with the practical nature of simulation generating more advantageous findings. This study provides useful information on the benefits and challenges of both types of delivery for foundational skills development and/or clinical preparation of allied health students.</p
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
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